Chronic Pain - Is it All in Their Head? - Daniel J. Clauw M.D

I know long-term pain changes grey matter. However, I also have real pain generating spine and nerve disease.

In his opening line talking about the volume nob being turned up is very accurate. Before the injury that causes chronic pain for people happens, all the volume settings for pain were default and worked well, but if those volume settings get tweaked during the injury (brain and spine) and your injury isn't healed relatively quickly the constant pain can begin to appear like it's affecting other areas a lot more than it might be. Other conditions or underlying conditions on top can exacerbate the problems to extremely high levels. But if you are suffering from chronic pain your only goal should be to at least understand or find out whats wrong, because you didn't feel like this before the injury and now it's been months maybe even years of suffering.

I sincerely people don't realize that your spine is an extension to your pain. Having your discs piercing into your spine and having a feeling of being electrocuted. There is no pain for nerve damage!! It's my spine! People don't get it. The nervous central being spierced all the time COMPLETELY has hand in hand. Completely intertwined. Thank you. They think we're nuts. Only Lyrica works and just barely. Please educate people know. Residual pain is not talked enough. Its so lonely sir.

Thank you.
Chronic pain for over 25 yrs. I was on a script pain med AND otc pain meds, most of the time 6-8 otc pain killers. Eventually I developed gut damage, liver and kidney damage. In 2015 I took things into my own hands, stopped all meds and focused on my diet, eating habits and lifestyle.
Sure, I'm still in pain, but at least I know where it is, where it originates etc... I have pinched nerves in several areas of the spine and my foot where I dropped a log on it back in 2005.

My question is, how much pain can a body cope with, what are the symptoms of extreme, can a body shut down when the body is in extreme pain?

At least he's not blaming it on witchcraft - but it still seems like we live in the Middle Ages.

Pain is in the brain. I suffered from chronic pain for over a year. As Dr Sarno says “you have to think your way out of this”. I am no longer in pain. You have to overcome yourself and have belief. I know it’s hard, you don’t need to preach to me. I have been there. No one can get you out of this but yourself. Trust me you will. Stop caring about it, distract yourself, do what feels good. Don’t let it bother you. You know it’s going to pass. It’s not even real. I typically hear all bullshit of the day -“how would you know” - because I’ve been through it “oh but how can I not care when I am in so much pain” - have you not been listening to me - I have been there and you just have to do it. There’s no easy path here or no shortcuts. If I can do it, anyone can. I am only leaving this comment to give others hope and let you know it is possible. No need to contact me. Start doing what you need to do. It will take as long as it takes. Have faith

Hello Doc. Can you help me? My favorite thing you said is spiral upward.

If you have chronic pain the only way out is to teach your brain your safe.

what a disconnected loser literally shifting blame of injury onto those who have the condition what a disgusting human being

So all of a sudden this volume turns up after years and years of not having issues with pain?! Of no issues with IBS, with muscle aches, and anything else...never a problem. I just don't fully agree. I was fine with the exception of headaches all my life, childhood on up until about 10 years ago. I would believe if I were sensitive to pain because of a volume in my brain that I would have been sensitive to pain all my life. I was pretty tolerant of pain. This just showed up one year and no matter how I think about it or not, meds, diet etc it worsens. I still stay as active as I can and do not just sit or lay around, I do as much as I can on good days, and the same with bad days. I would like to understand how this "volume" turns up randomly.

Is there anyway to get the paper and meds list that we werew told to bring to our doctors?

This man here, he HAS a serious problem

It's always interesting that so many in the medical field feel the need to tell us that our pain is "in our heads" and isn't a warning system devised for us to pay attention to, treat or even find answers for. It's further interest of mine to know they don't have chronic pain to know what we live with. We know that pain is a signal from the body to the brain that there is something wrong going on. We also know that there isn't ONE "right" answer on what will either calm down the body or brain to meet the doctor's assessment that what we are doing is the "right" thing. Pain maybe subjective to those who don't experience it, but for us that live with it, realize that it needs more than glib answers to help us.

I have bursitis in every joint and tendernitis of my hips I don't think that's in my brain

I won’t even bother watching this. You can tell that disguise answer is going to be suck it up. It’s all in your head and that you have nothing wrong with you. Meanwhile, he’ll sit back at home with a bottle of Xanax in his own personal prescription of Percocet and snicker, while he lives off of your misery.

This man has never had his ass beat, or had a bone broken and you can tell with his snickering snide attitude

Please start using the mJOA ALONG with your fibro questionnaire. 20 years ago y'all said I had fibro but it turned out to be a severe cervical cord compression. I'm still stuck with the fibro label and cannot get treated for the underlying myelopathy. It's too late for me but adding the mJOA could prevent the misdiagnosis for others. My life has been crippled by the misdiagnosis. Please don't ruin other peoples lives.

Contrary to current political and general belief, we DO have medications called opioids which can and DO help many people with chronic pain. These are legal drugs which have been vilified and made very hard to prescribe by providers who treat patients. This is due in large part to the so called "opioid crisis", which certain parties used to include legal opioids, when the REAL problem as we now know was caused by illicit fentanyl mixed with other street drugs. Chronic pain patients have always had low rates of addiction, but the current state laws which were mostly due to the CDC's medically incorrect "guidelines" have helped create a situation in which our government seems to want to prohibit these legal opioids. So-called "legacy" patients, who were taking legal opioids for many years to ease 24/7 pain from many causes are being forgotten, and are now dying and/or being harmed by current policy. Many patients who were stable taking high doses of opioids are being cut off or having their doses cut so much that they become ill. No patient who has successfully been taking legal opioids for pain and had their quality of life and productivity given back to them should ever have to experience what is happening now. I urge anybody who believes our doctors and not the government should make decisions on treatment of pain with their patients should write to their legislatures and urge them to loosen up the state laws which are killing people. All of us are one illness or accident away from becoming incapacitated by pain. Legal opioids DO work for millions of people, who are now apparently being forgotten and made to suffer unfairly. We cannot pander to addiction so much that another group of people is made to suffer. Addiction is not the same thing as dependency, and dependency is merely a side effect of daily opioid therapy. If medications are appropriately and safely being used to help people who suffer daily otherwise, there is no good reason that they should be taken away from patients who need them to remain functional. We must insist that our medical providers stop being persecuted like criminals for treating something that can cause illness and early death. Pain is real,, and it is not a joke. It harms the body. I beg to differ with those who believe that psychological therapies will work for everyone. They will not. Pain is not a mental illness. We must support ethical treatment and oppose prohibition of these drugs, which have safely been used for centuries.

YOU ARE A FUCKING IDIOT TO BELIEVE CHRONIC PAIN IS ALL IN YOUR HEAD!!! I've been on opiates for 13yrs and have tried numerous times to go with my pain medication. I do not suffer from withdrawals, but the pain forces me to take my pain medication or literally not wanting to live...

Based on a quick goggle search and reading his article this guy is wrong. I’m not going to waste my precious time to watch his videos. Based on his quick reference of the difference of poly myalgia and fibromyalgia he is completely wrong. I have had fibromyalgia for about 15 years or longer and the literature always read everything for poly was for fibromyalgia and that is correct. Not what he says. Fibromyalgia is an autoimmune inflammatory condition u feel flu like symptoms in primary in neck shoulder hip areas and in 18 primary points of the body in the glut in the chest even your hair hurts when your experiencing an flair or bout of inflammation. It’s very insulting when some dork like this and his information says that it’s minimal or a small amount. He has absolutely no idea what he is talking about. The literature has always been correct until I just search fibromyalgia inflammation and his misinformation came up as the first as it not being an autoimmune condition. Weekends come and I lose the entire weekend sometimes cuz I need to crash from fatigue and pain. Both poly and fibromyalgia are both widespread pain arthritis comes from the bones arthritis has always been related to the bones not the muscles. Which is the tenders and all that. Now they refer to arthritis as muscles ok no. Fibromyalgia is a central nervous trigger hello the pain is trigger and over activates the muscles higher than they should be. I’m very person normal or not gets their signals from their brain to move a body parts so all pain is affect via the central nervous system idiot. And to say it’s mild or low grade. I would love to lay a few bricks on a body suit all over his body a few on his shoulders, head, back, hips all around the body on top of his head all the way down to his feet and ask him by the end of the day. How do u feel now? U will be exhausted and eventually crash which is why you get so fatigued. Is it always like this no but u can get flair ups. It’s lifelong some months are worse than other diet plays s big roll but even taking aleve with highly sensitive reactions that aleve can make u feel even more tired than u did before with the pain. U always have pain. U just get so immune to the neck of shoulder pain that finally during the day u finally say wow I feel horrible today. Why? Oh crap it’s going to rain tomorrow u feel it in your body specifically ur neck and shoulders and all those tender points. Or god what did I eat to cause this inflammation todsy. Oh yeah I had this and that things that cause INFLAMMATION from IBS related foods that trigger and bring down you body. This guy is a complete idiot. And just because he has s degree doesn’t make him correct. Let’s not forget they want to change lingo like the homeowners insurance company do when they called sandy a hurricane to a superstorm for the benefit of the insurance companies being off the hook. So let’s not forget the financial benefits of pushing head pills verse taking an over the counter aleve. For those experiencing fibromyalgia it’s this if you haven’t learned your body yet. They trained to give me these head and body pills and of course cuz we have more or highly sensitive censor ones with our bodies the side effects can hurt more than the condition itself. The problem is sugar in our diet fake sugar. Go read a real doctor and professor who knows what he’s talking about who wrote the book metabolical. Let me tell u, robert lustig knows what he is talking about and it’s s natural approach to manage ur condition. Eat natural. All this crap in our foods is killing us. Once I ate better guess what I felt so much better. U don’t need pills manmade pills to keep making these doctors and big pharm rich off u the addict who thinks u need it. Let ur medicine be natural food. Go back to cave man menu. Animals for protein and fruits and veggies no crap processed food no fast food no soda no junk food it’s all inflammatory. Ur gut is the main hub for your overall health don’t be told it’s all in your head when u clearly feel it in every fiber of your body. What u put in your gut will have a profound result on how the rest of your body feels. Trust me. Get enough sleep. Eat good light consistent exercise and listen to your body. Certain things like food, change of weather and crumby nights sleep can put you in s really bad flair up and crest a lot of excruciating inflammation. And even when u do so all the right things some days are worse than others. Just get the rest u need elimste those out of your life who stress u out even ur parents or even kids. Drop their little ssses off at some group class or whatever a few hours out of the day or evening. Do what u need to do for yourself. Cuz if u don’t put ur foot down for u u won’t be any good for anyone else. U can’t carry the world on your shoulders when u already carry enough with fibromyalgia. Go rest. Don’t listen to this dork he doesn’t know what he’s talking about and don’t forget he needs to line his pockets and big pharm for his kickbacks too. God put these foods on earth for us, only man made all these crap medications. God wants u to feel good and go to heaven one day. He’s not looking to strike it rich off if you purchasing his food verse purchasing a doctors visits and big pharm prescriptions.

This guy is anti opioid. Waste of time and breath. Pious ah. The deaths are happening to illicit drug users not chronic pain patients taking prescription medication.

these doctors have sold out there patients to being suck ass yes men everything we have learned about pain managment is all being cast asside due to politics and lying ass doctors trying to cover their own ass our system is broke this doc is trying sell the idea that its all in your head...nice job .how about if someone beats the crap out of you in surgery when you come to you are told to take nsaids keep selling your lies suck ass doctors nice job disgusting.

DDD, DJD, progressive sensory neuropathy, fibromyalgia, kidney disease, gout, bicep tendon injury, etc.... and I'm at the point now where it's taking so long to see a new pain management doc that I wonder how much longer until I snap and opt out. (I saw the other doc for nearly 15 years on and off- I'd take breaks from opiates by choice- but he moved too far for me to drive). I guess these folks who don't have chronic pain don't "get" that it gets down to suicide or illicit drugs - for those who can still go out and look for them. The rules for those who don't follow the rules are killing those of us who do. I'm in favor of doing what I can- medication or not- but when I can't move, I can't do much. Thanks for adding to the stigma of just wanting enough medication to be able to function. Cannabinoids are somewhat helpful (CBN, CBC, CBG, CBD, hemp THC, HHC, and delta 8 THC from hemp), but they don't do a lot for my femur scraping across my tibial plateau or my hips grating in the sockets. I worked as a detox RN for several years, and between the former addict 'preachers' against any pain meds along with the media's emphasis on addicts, and NOT those who follow the rules, and being a chronic pain patient in this country is a source of shame and stigma.

Wow! So refreshing to hear this. I've been living with chronic pain for may years and it continues to get worse. In my case it comes from many different areas. I've had MRI's and X rays that show nothing so doctors have no solutions for me. Just hearing you say some of these things makes me feel like I'm not crazy.

Where is the references article he wrote??? No link provided.

Someone who doesn’t have chronic pain has no business speaking about it.

The so-called "opioid crisis" was largely due to the illegal Fentanyl streaming across the southern border, which then got mixed in with legit drugs such as hydrocodone. Then the whorish media, always in search of a sensationalized story, stepped in, and not a day would go by that you wouldn't see a headline screaming -- Opioid Crisis.

Sure, there were a few docs who were pill-pushers and some patients who abused the system, but to cut off the majority of responsible patients suffering from chronic pain completely from the one thing that will allow them to live a full life -- synthetic opioids -- is sheer insanity.

Then the pimp politicians, state AGs, the DEA, the CDC, and greedy plaintiff attorneys stepped in and scared docs and some pharmacies into submission, while reaping in billions from Big Pharma.

I asked one pain management doc the other day, just out of curiosity, if he prescribed pain meds to his or her patients, and he said "no."

Meaning, here is a physician specializing in pain management, no less, who has taken synthetic opioids completely off the table. It's maddening and insane. A pox on all their heads. Trust me, if you live with chronic pain as do I, osteoarthritis, cervical spondylosis, lumbar arthropathy, peripheral neurology, the only thing that helps is the simple fact that I have a good physician who still prescribes, as long as I do the annual drug test, etc. I pity those unlike me who can't find a sympathetic physician who actually cares about his or her patient.

Meanwhile, those in the public realm who still condemn opioids can go drink as much alcohol as they want. It's a messed-up world.

Anyone who is struggling with migraines that make you throw up or joint pain, it could be your diet. Learning that foods were giving me chronic pained. Changed my life, turned out it was gluten and food my body can’t handle that was making me sick and full of pain.

I love this video. To see someone who doesn't feel much pain going over,in detail, the dynamics of pain, and I don't mean that facetiously. I appreciate it. This guy is really helpful. The problem I have is that (being a high fibro index person) I have facet arthritis and severe head pain due to various forms of "headaches." For me the pain is absolute torture. My blood pressure soars to 215/140 and I fear stroke/aneurysm. I have been on the firbo drugs well before the dx, but without an acute/ emergency pain drug, I'm left screaming, passing out, etc On 9 to 10 pain several days a week. I only need the smallest dose of opiod avail which I assume is 5mg but I cannot get any help and end up in the er with morphine (after suffering immensely for many hours.) I see neurologist and pain/spine specialists. What does a person in my situation do? I cannot continue without help and trust me I use all of the ice packs I can. They do help. They don't help enough. I had a hip replacement and the after pain was nothing compared to this and I had help. Idk where to go to be understood. A lot of doctors say I believe you but that doesnt matter to us with pain. We truly need to be understood and I feel this presentation does make me feel understood for the most part. I would just love to know what Dr. Clauw would recommend in a situation like mine where yes, the volume is maxed out but the actual conditions causing the pain sessions are real and extreme and need acute, survival level help.

All pain and disease, is emotional entity attachment, from trauma and can also be carried over from past lives. Release the emotions or entity, the pain just leaves. People don’t need to suffer.😢

Opioids are preferred by 80+%.

So, what he appears to be saying is that pain is in your head. Don't buy it. Pain is complex, but alternate therapies are adjuncts, not primary treatments to acute or chronic pain. I don't trust those who demand that you leave a treatment that works for you and move to a treatment that does not work well for you. Demand meaning that the powers that be have decided that a treatment that has worked for years should be removed because you just might become tolerant of the treatment or, unlikely as likely, become addicted.

Pain causes stress and stress leads to more pain. a vicious cycle. Take care of the pain and you diminish the stress.

God forgive me, but I would like this quack to experience intense chronic pain that will NEVER go away. He makes me sick.

Okay my Dr said watch this. Tore rotator cuff hurts, 3 front neck surgeries, 1 back neck surgeries, three foot sugeries and Fibro on top of it.... I have Chronic Pain. Arthritis in hips, pelvis, spine, right collarbone, right shoulder live in pain all the time only on pain pills after sugery. Chrronic pain is real.

QUACK!!! SHAME ON YOU!

“Volume Control” is often associated to fight, flight, freeze.

I have been in fibro studies since I was 20 at U of M (dozen or so fMRIs done) and over the years ppl always said go see Dr. Claw. I understand a lot of what he is saying…but I have so many overlapping conditions some of what I was born with, that it would be nice to get help for, have quality of life and not just be judged because it’s in our “heads” and it says fibro on my chart 🤦🏻‍♀️.
I live CBT…spoons.

I am super sensitive to meds and flunked out of the drug trial Lyrica because of a rare side effect and was asked not to do any more drug trials at u of m..can’t skew results on the studies🙄.

I have been trained and have a lot of tools in my toolbox, but have recently received a pain med that helps turn down the hyperalgesia and it is an opioid. The other meds become more effective. 🤷🏻‍♀️
Sure antidepressants SSRI/SNRIs. or anti seizure meds work for some but not for everyone (myself included) and it would be nice to be treated like a human through the process.

See the “health care” is actually sick care so it does not do well in taking time with people already in fight or flight and treating pain conditions because we need a “wholistic” - whole body approach and care for ourselves and the system does not have the time and space (insurance coverage) to help guide us through all of areas we need help in.

I had eye cancer had 3000 rads of radiation. After treatments my pain escalated. No one knew what was wrong. Endured 18 months of nerve block injections to scalp, temple, cheek etc 18 months!! Pain worsening needles unbearable I begged for surgery. Nerve avulsion done electrocutions didn’t stop. Nerve Ablation done no improvement. A wire stimulator implant like a tens unit installed turn dial or set on auto now every electrocution was hit with an electrocution…I couldn’t beat double the shocks unit removed. FINALLY BRAIN SURGERY was done big disc of skull removed from back of my head, surgeon skirted around inner cranium to trigeminal area. He was SHOCKED!! A huge mass of melted nerves at the left ganglion pons!! No way to identify which nerve was which or separate and cushion like a MVD (micro vascular decompression) used often for trigeminal patients. I was woken i during brain surgery to make sure I could speak, see, listen, lift arms, follow instructions etc. surgeon did snip a few places but high fish mess! He carefully backed out and closed. My electrocutions continued to throw me out of chairs, throw me off my feet…it’s just like being hit with a tazzer. My GP retiring I am now victim of physician’s prejudice could not get a doctor even though I put urgent on every applications at a thousand clinics from Niagara Falls to Windsor Ontario. A friend up north found me a clinic not narcotic prejudice and perfect lowest effective dose meds set up by Neurologist and well documented!! We were forced to sell our home leave our freinds, lost our garden, was a very expensive move 800 kilometers north! Now that doc has left and I am told other doc won’t prescribe my narcotics. This is evil cruel uncalled for. Narcotics were last resort for me. If this doctor refuses I will be forced to either find pain relief from illicite narcotic killer drugs on the street or end my life. There are no surgeries left to undo this trigeminal ganglion pins damage caused by radiation. Narcotics are a good tool to physcians and a Primary care doctor is perfectly able to follow my specialists instructions of does and letter states “do not discontinue”. My extreme damage and agony is cancer related!! It’s very real. Every option was tried. Any fool who thinks mediation, calming music will help this is uneducated! It’s wrong to remove a very effective treatment that has given stable relief for years. Doctors forcing patients to seek relief on the streets, kill themselves or go to assisted dying are guilty or manslaughter, guilty of patient abandonment! What happened to DO NO HARM? CPSO in Ontario set a guideline but also stated physcians use best discretion and any “no narcotic blanket policies are not permitted” but CPSO refuses to clarify their guideline to prevent new minor acute addictions and leave chronic severe patients stable.CPSO and doctors are denying pain relief and killing people. I sold my paid in full home, I moved 800 km, I want to live!! Please Dear God I want to live.

This is the most ridiculous thing I've ever watched.😡

Please come up with solutions, and start engaging with different engineering and science disciplines. Chronic pain can take you from a high pain tolerance to a low pain tolerance very quickly. I have lost so much respect for the medical community.

I have severe pain in both feet and a little less frequently in both hips. There are identified causes. However, patterns in severity are hard to see. The only clear correlation I see is to sleep; better sleep less pain.

Unbelievable, no idea about how chronic unrelenting pain impacts lives. While CBT can be effective in managing pain and pain management strategies can help to assume brain pain is the issue when you yourself do not experience pain just shows a total lack of empathy and compassion. Try experiencing relentless burning searing nerve pain where you can’t sleep, can’t stay in one position and can barely function then come back and redo the lecture…

Drug dealer! Stay away from all these ssri’s and other psycho - mind altering drugs! It’s satanic!
Please people.

Hydrocodone is the only thing that worked for my wife even thought she tried everything else for 20+

When I was a teen I had knee pain that the first three doctors thought was in my head. The fourth doctor actually looked at the X-ray and found a bone chip bigger than Dallas.

After the bone chip was removed, the pain went away.

The problem is you guys won’t ever prescribe opioids on an as needed basis

This fearmongering about opioids is harmful to pain patients. So much for being a "thought leader"...

This is terrible, I have chronic pain yet I have a score of 28 on the fibromyalgia test. I dread waking up if I’m lucky enough to sleep. I’m exhausted all the time bed ridden. The pain is at the worst in my lower back however the pain anywhere is dealt with by the brain it’s like a computer and the processor it deals with everything like our brains. The brain processes the pain anywhere in the body.
WAKE UP DOCTOR PROFESSOR OR WHATEVER YOU ARE!!! 🤬😂I’m on morphine duloxetine paracetamol lanzoprazole and naproxen. I am still bedridden. Stiff all the time pain constantly as well as migraines and light sensitivity

I’m scared of my pain leading to a stroke or an aneurysm. Everyday I freak out. It sucks. The only remedies that help are gabapentin or Xanax but I don’t want to take either.